Provider Relations Senior Advisor – National Ancillary Medicare Advantage Vendor Service and Operations (Remote)

This is a Medicare Advantage position.

Work Location: This is a Remote position

The National Ancillary Senior Advisor is a key role that supports Cigna's Medicare Advantage line of business, directly addressing customer and client demands for higher quality of care and greater affordability for the senior population. The primary focus for this role includes driving and/or supporting the vendor service strategy, relationship management, business process improvements, operational efficiencies and effectiveness, and service performance outcomes within their assigned segment(s). 

The Senior Advisor will monitor, assess and evaluate National MA vendor programs relative to Cigna policies and procedures as well as CMS/regulatory guidelines, and its downstream impact to Cigna MA Customers.  This role will execute on the service strategy, planning, delivery and corrective action planning for their assigned segment(s) to deliver program value.  This is a high functioning role with relationship management, account management, service delivery, and strategic planning responsibilities.  The Senior Advisor will work closely with the National Ancillary Service and Operations Lead to develop and execute strategic business initiatives in support of overall vendor management and oversight, by collaborating across internal and external business partners to achieve desired outcomes.  In this capacity the Senior Advisor may need to develop and deliver specific training / education to ensure key stakeholder alignment.

Key Responsibilities:

• Manage end-to-end relationship

• Facilitate Vendor/Provider Governance – JOCs, Operational Touchpoints, Strategic Alignment

• Monitor progress against goals, including Vendor/Provider performance metrics, internal SLAs

• Manage vendor/provider renewals, termination and replacement process

• Collaborate with matrix partners to ensure vendor/provider compliance, conduct pilots within MA, project planning, etc.

• Assess and implement marketing campaigns

• Identify and resolve day to day operational issues

• Conduct root cause analysis, trending and course correction

• Timely escalation of barriers to success along with identification of potential solutions

• Ensure vendor/ provider 1/1 Readiness

• Support Sales training, vendor fairs/ event planning, etc.

• Facilitate and validate vendor invoices to ensure payment accuracy and timeliness

• Develop, review, deliver accurate and timely reports

• Develop and maintain integrated project / work plans

Qualifications

• Bachelor’s Degree required; MBA and/or Masters in relevant field also valued

• 5+ years experience in Health Care/Managed Care Programs and/or Operations, required

• 2+ years Relation Management experience, required

• Medicare experience, highly preferred

• Clinical experience working with Clinicians, is a plus

• Relationship Management experience

• Ability to think strategically

• Leadership mentality

• Result-oriented with demonstrated project management skills

• Strong analytic and decision-making abilities

• Ability to foster collaboration, value others’ perspectives and gain support and alignment for organizational proposals

• Courage to offer and defend opposing viewpoints

• Problem solving and root cause identification skills

• Excellent oral, written, presentation and overall communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand as well as the ability to understand and interpret information from others

• Comfortable interacting with multiple senior leaders both internally and externally

• Understanding of medical insurance products and associated Ancillary, vendor/provider & customer issues

• Demonstrated ability to influence decisions in support of Medicare Advantage vision & strategy

If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.

For this position, we anticipate offering an annual salary of 90,800 - 151,400 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

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